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Official Journal of the Society to Improve Diagnosis in Medicine (SIDM)

Editor-in-Chief: Graber, Mark L. / Plebani, Mario

Ed. by Argy, Nicolas / Epner, Paul L. / Lippi, Giuseppe / Singhal, Geeta / McDonald, Kathryn / Singh, Hardeep / Newman-Toker, David

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Roots of the total testing process

Matthew L. Rubinstein
  • Corresponding author
  • Rutgers Biomedical and Health Sciences Lecturer, Rutgers University, Clinical Laboratory and Medical Imaging Sciences, School of Health Professions, 65 Bergen Street, GS-01, Newark, NJ 07103, USA
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Published Online: 2019-10-04 | DOI: https://doi.org/10.1515/dx-2019-0065


Laboratory professionals can contribute to improvement of diagnosis in the context of the total testing process (TTP), a multidisciplinary framework complementary to the diagnostic process. While the testing process has been extensively characterized in the literature, needed is accurate identification of the source of the term “total testing process”. This article clarifies first appearance of the term in the literature and supplies a formal definition.

Keywords: clinical laboratory; diagnostic process; total testing process


  • 1.

    Schiff GD, Kim S, Abrams R, Cosby K, Lambert B, Elstein AS, et al. Diagnosing diagnosis errors: lessons from a multi-institutional collaborative project. In: Henriksen K, Battles JB, Marks ES, Lewin DI, editors. Advances in patient safety: from research to implementation (Volume 2: Concepts and Methodology). Rockville, MD, 2005.Google Scholar

  • 2.

    Balogh E, Miller BT, Ball J, Institute of Medicine (U.S.). Committee on Diagnostic Error in Health Care. Improving diagnosis in health care. Washington, DC: The National Academies Press, 2015.Google Scholar

  • 3.

    Plebani M. The detection and prevention of errors in laboratory medicine. Ann Clin Biochem 2010;47(Pt 2):101–10.Web of SciencePubMedCrossrefGoogle Scholar

  • 4.

    Baird G. Preanalytical considerations in blood gas analysis.Biochem Med (Zagreb) 2013;23:19–27.PubMedGoogle Scholar

  • 5.

    Hawkins R. Managing the pre- and post-analytical phases of the total testing process. Ann Lab Med 2012;32:5–16.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 6.

    Hickner J, Graham DG, Elder NC, Brandt E, Emsermann CB, Dovey S, et al. Testing process errors and their harms and consequences reported from family medicine practices: a study of the American Academy of Family Physicians National Research Network. Qual Saf Health Care 2008;17:194–200.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 7.

    Litchfield I, Bentham L, Lilford R, McManus RJ, Hill A, Greenfield S. Test result communication in primary care: a survey of current practice. BMJ Qual Saf 2015;24:691–9.CrossrefWeb of SciencePubMedGoogle Scholar

  • 8.

    Bonini P, Plebani M, Ceriotti F, Rubboli F. Errors in laboratory medicine. Clin Chem 2002;48:691–8.PubMedGoogle Scholar

  • 9.

    Boone J. Is it safe to have a laboratory test? Accred Qual Assur 2004;10:5–9.CrossrefGoogle Scholar

  • 10.

    Lundberg GD. Acting on significant laboratory results. J Am Med Assoc 1981;245:1762–3.CrossrefGoogle Scholar

  • 11.

    Gambino SR. Met and unmet needs of the automated clinical laboratory. Trans N Y Acad Sci 1970;32:816–20.PubMedCrossrefGoogle Scholar

  • 12.

    Martin ML, Addison BV, Wagner WM, Essien JD, editors. 1989 Institute on critical issues: improving the quality of health management through clinician and laboratorian teamwork. Wilmington, DE: The Du Pont Company, 1991.Google Scholar

  • 13.

    Barr JT, Silver S. The total testing process and its implications for laboratory administration and education. Clin Lab Manage Rev 1994;8:526–42.PubMedGoogle Scholar

  • 14.

    Inhorn SL, Addison BV, editors. 1986 Institute on critical issues in health laboratory practice: managing the quality of laboratory test results in a changing health care environment. Wilmington, DE: The Du Pont Company, 1987.Google Scholar

  • 15.

    The Lewin Group. Laboratory medicine: a national status report. Prepared for Division of Laboratory Systems, Centers for Disease Control and Prevention, 2008.Google Scholar

About the article

Received: 2019-09-05

Accepted: 2019-09-11

Published Online: 2019-10-04

Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Author declaration: This paper is exempt from ethical approval.

Citation Information: Diagnosis, 20190065, ISSN (Online) 2194-802X, ISSN (Print) 2194-8011, DOI: https://doi.org/10.1515/dx-2019-0065.

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